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Summary articles Sustainability, Health and Innovation (GEO3-2266)
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Summary articles1. Access to global health interventions
Anti-malarial drug development and diffusion in an era of multidrug resistance: how can
an integrated health framework contribute to SDG3? - de Haan & Moors (2020)
Sustainable drug development = medicines that are acceptable, safe, affordable and accessible
for the ones in need → relates to sustainable development goal (SDG) 3 = ability to ensure
healthy lives and well-being → problematic in LMICs (Low- and Middle-Income Countries).
Availability Initiating and performing R&D to address unmet medical needs and adequate supply of
products → open access to share knowledge and stimulate open innovation for drugs.
Affordability Medicines should be affordable to governments and patients in resource restricted settings.
Accessibility Inclusion of effective and safe medicines in global and national treatment guidelines.
Acceptability Getting drugs accepted by prescribers and patients by offering drugs without too many side
effects and risks → products tailored to specific needs.
Malaria = a poverty related infectious disease that is caused by parasites and transmitted
through mosquitoes → well treatable, but drugs often fail to reach the infected patients → the
first-line anti-malarial medicines are becoming less effective because of multi-drug resistance.
Sustainable healthcare: on the one hand, there is pressure from society to develop innovative
medicines that address unmet medical needs → on the other hand, the development of these
medicines is expensive while health budgets are limited.
→ barriers to a sustainable pharmaceutical system for LMICs:
- The development of new medicines is resource intensive, but commercially unattractive.
- The interests of stakeholders are often poorly aligned or even conflicting.
- Healthcare systems are fragmented and characterized by a shortage of resources.
→ solution: a larger role for public research institutes in the discovery, clinical testing and safety
evaluations of new drugs.
Required adaptations for the pharma system: (a) sustainable, innovative drugs should be
developed and rapidly made available. (b) affordability of next generation drugs needs to be
ensured, (c) appropriate drugs should be included in global and national guidelines, (d) drugs
without too many side effects and risks and adapted to end-user preferences should be offered.
Market Formation in a Global Health Transition - de Haan et al. (2021)
Innovation systems framework = transitions are a result of interactions between actor networks
and institutions involved in the generation, diffusion and utilization of techs → 2 characteristics:
(1) research, development and deployment of therapies takes place at different geographical
scales and in various countries.
(2) the uptake of innovative therapies for poverty-related infectious diseases has been slow
and challenging, even when drugs are clinically
superior to failing alternatives.
Anti-malarial drug resistance is a consequence of: genetics and
natural selection, reinforced by their short lifecycle and rapid
reproduction → some parasites survive treatment and have an
evolutionary advantage over drug susceptible parasites and
may then become dominant.
, Multi-scalar innovation system = establish more sustainable drug regimens by involving
multiple actors, networks and institutions on different geographical scales and locations.
→ public sector distribution channels: are top-down coordinated by national governments.
→ private sector distribution channels: are more diverse, unsupervised and commercial in nature.
→ multi-located systems are
effective through the organization of
structural couplings = linkages
between actors, networks or
institutions.
Market formation = markets are
crucial to the long-term success of
innovative techs → 3 market
formation subprocesses: (1) market
segmentation (specific product categories or end-user groups), (2) market transactions
(exchange relationships between suppliers and customers), (3) end-user profiles (active role of
users and consumers by developing preference structures and utilization practices).
Can medical products be developed on a non-profit basis? Exploring product development
partnerships for neglected diseases - Muniz et al. (2015)
Neglected disease = create a large burden in developing countries, but have little or no impact in
the developed world → firms invest little R&D in medical products for neglected diseases, due to
the: (a) high risks and costs, (b) problems of R&D financing and (c) inappropriability of returns.
Economic barriers to R&D: (a) commercial markets are small, (b) individual purchasing power is
limited (even though the number of patients may be very large), (c) high R&D costs and the risk
that it will not be covered by returns on investments → incentivize R&D in neglected diseases by:
push mechanisms: bring down firms’ costs of limitations; (a) it may not provide sufficient incentive for R&D, (b)
R&D → FEX. grants, tax credits and loans. it is vulnerable to lobbying.
pull mechanisms: increase market limitations; (a) it rewards the output (new medical products)
attractiveness by lowering the risk of R&D and rather than the pay for inputs to R&D, (b) limited practical
assuring revenue for the outputs → FEX. experience with pull instruments for neglected diseases.
milestone or end prizes
Other ways to stimulate medical innovation: open models = collaboration, sharing of info among
volunteers and open access to data → FEX. product development partnerships (PDPs) = private,
self-governing, non-profit R&D organizations → characteristics: PDPs...
- are system integrators and brokers → bring about innovations in areas where no private
or public institutions can or want to do the task alone.
- are health innovation ecosystems that reach beyond national
boundaries → community of organizations (suppliers and
sources of knowledge), institutions (regulatory authorities
and government bodies), and individuals (managers,
policy-makers and patients).
- develop system integration capabilities to engage and
leverage diverse resources and capabilities.
Focus public sector: discover and create knowledge and translational
research (upstream) → focus private sector: product development,
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